新型冠状病毒感染疫情隔离管控期间上海和苏州地区儿童呼吸道部分病原体流行特征分析

The prevalence of respiratory pathogens in the children living in Suzhou and Shanghai,China during strict COVID-19 quarantine

目的通过对儿童呼吸道5种常见病原体IgM检查结果进行分析,探索上海和苏州两地这5种病原体在新型冠状病毒感染(COVID-19)疫情期间严格隔离管控条件下真实世界流行特征的变迁。方法该研究是一项基于医院的回顾性横断面人群研究,在上海和苏州两地开展,共收集了187054例门急诊患儿,用多重免疫检测法测定人血液中5种呼吸道病原体的IgM抗体,包括肺炎支原体(MP)、肺炎衣原体(CP)、呼吸道合胞病毒(RSV)、腺病毒(ADV)和柯萨奇病毒B(CVB),并用多变量logistic回归模型评估儿童各基线特征与呼吸道病原体之间的关联。结果5种儿童呼吸道病原体的IgM抗体阳性率为0.66%~17.44%,以MP为最高。儿童MP阳性率最高的年龄段是1~3岁(31.34%),而CP和CVB阳性率最高的均是1岁以下婴儿(CP为9.74%,CVB为1.13%)。RSV的阳性率总体水平低且随年龄而增加。此外,居住在上海地区的儿童感染ADV的概率(6.24%)较苏州地区的高。在上海研究人群中,发现年龄、就诊年份、居住的城市与检测的5种呼吸道病原体感染显著相关。在苏州的研究人群中,也发现了类似的结果。结论COVID-19疫情期间5种呼吸道病原体检测的阳性率发生了显著的变化,CP和ADV感染增加,而MP、RSV、CVB感染降低,提示呼吸道传染的严格管控措施可以改变部分病原体的流行特征。

Objective To investigate the real-world epidemic characteristics of the five common respiratory pathogens by analyzing the corresponding IgM antibodies in the children living in Shanghai and Suzhou during the COVID-19 pandemic with extremely strict prevention and control strategies.Methods A retrospective cross-sectional hospital-based population study was carried out in Shanghai and Suzhou.A total of 187054 outpatient and inpatient children were recruited.A multiple immunoassay panel,including Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP),respiratory syncytial virus(RSV),adenovirus(ADV),and coxsackievirus B(CVB),was used to detect the 5 IgM antibodies in human blood against multiple respiratory pathogens.Multivariate logistic regression models were used to investigate the association between baseline characteristics and the risk of infection by respiratory pathogens.Results The prevalence of IgM antibodies of respiratory pathogens ranged from 17.44%to 0.66%.The prevalence of anti-MP IgM antibody was the highest,especially in children aged 1-3 years(31.34%),while the highest prevalence of CP and CVB was found in children under 1 year old(9.74%for CP,and 1.13%for CVB).The overall positive rate of RSV was low and increased with age.In addition,children living in Shanghai had higher probability of ADV infection(6.24%)than the children living in Suzhou.In the total study population,age,year of visit,and city of residence were significantly associated with the risk of infection by the five respiratory pathogens.Similar results were found in the children who lived in Suzhou.Conclusions The present study indicates that the prevalence of the five common respiratory pathogens changed evidently in the context of extremely strict prevention and control strategies during COVID-19 pandemic,increased CP and ADV infections and decreased MP,RSV and CVB infections,which may have a profound impact on the epidemic characteristics of the five common respiratory pathogens.